Efficacy of Proprioceptive Neuromuscular Facilitation on Posture in Parkinson Disease: A Randomised Controlled Trial.

Parkinson’sdisease is second most common neurodegenerative disease. Parkinson’s disease orParalysis was first described as “the shaking palsy†by James Parkinson in1817. It is chronic, progressive degenerative disorder of nervous systemcharacterised by cardinal features of rigidity, akinesia, bradykinesia, tremorsand postural instability.About 5 million people are affected worldwide.Prevalence rises from 1% with those with 60years age to 4% in population over80 years.

Thedisease is slightly more frequent in men than women. The prevalence of thedisease is generally accepted to range from 100 to 200 per 100,000 people andthe annual incidence is thought to be 15 per 100,000.

Parkinsondisease is a disorder of the dopamine producing neuron of the substantianigrain the basal ganglia. The substantianigra is subcortical grey matter thatcontain pigmented neurons. The severity of loss of dopamine correlated wellwith the amount of movement slowness or bredykinesia exhibited by the patients.Loss of dopamine neurons and the production of lewy bodies within the pigmentedsubstantianigra neurons are hallmarks of idiopathic Parkinson disease.

Fourmotor symptoms are considered cardinal in PD: tremor, rigidity, slowness ofmovement, and postural instability. The range of other motor symptoms includeposture and gait disturbances such as a forward-flexed posture with a typicalfestinating gait.1 Forward head posture (FHP) is the anteriorpositioning of the cervical spine. It is the most common deviation from thenormal curvature of the cervical spine. It involves an excessive anteriorposition of the head in relation to the theoretical plumb line perpendicular tothe body centre of gravity. In forward head posture there is extension of uppercervical spine, flattening and flexion of lower cervical spine with an increasein lordsis and rounding of the upper back and elevation and protraction of theshoulders.4Physiotherapy treatment i.e. PNF and resisted exercise isbetter to improve range of motion and forward head posture in Parkinson’spatients.

Need of the study:

Parkinson’sdisease affects 1–2 per 1000 of the population at any time. PD prevalence isincreasing with age and PD affects 1% of the population above 60 years. Theposture in Parkinson’s disease deteriorate. Forward head and stooped posture isvery common in these patients. Pharmacological treatment doesn’t cureposturalinstability. Hence physiotherapy correction i.e. strengthening exercises andPNF techniques are very effective in treatment of forward head posture.